Assessment and intervention of the upper limb in children and adolescents with unilateral cerebral palsy: A cross-sectional study

Introduction: Occupational therapy aims to support children with unilateral cerebral palsy (UCP) by enhancing upper limb (UL) function and promoting participation. Although evidence strongly endorses specific assessment tools and interventions, their consistent application in clinical settings remains unclear. Aim: This study explored the clinical practices of Spanish occupational therapists in assessing and treating children with UCP, focusing on UL function, participation and somatosensory processing. Method: A cross-sectional online survey was distributed to occupational therapists working with paediatric neurological conditions in Spain. The questionnaire comprised 32 items across three domains: demographics, assessment and intervention. Findings: Of the 130 respondents, 57.7% used standardised assessment tools, yet only 17.7% were aware of their validation status. Somatosensory processing was assessed in fewer than half of the cases by 32.3% of therapists. Intensive therapies were employed by 30.77%, with only 12.5% adhering to recommended dosage guidelines. Common conventional approaches included bimanual activities, play, activities of daily living re-education, somatosensory stimulation, adaptations and assistive devices. Some therapists also incorporated emerging therapies. Conclusion: The findings reveal a gap between evidence-based recommendations and clinical practice, particularly regarding somatosensory assessment and intensive interventions. Enhanced professional development is needed to support the consistent use of validated tools and structured strategies.